Deep brain stimulation useful for Tourette syndrome

The use of deep brain stimulation (DBS) for the management of Tourette syndrome can relieve symptoms in some cases, but cause distressing side-effects in others.

DBS – the insertion and use of electrodes known as neurostimulators into sections of brain – is an option for the management of several neurological disorders, including Parkinson’s disease, chronic pain and obsessive-compulsive disorder. However, its trial use in people with Tourette’s has been infrequent.

In a paper for the journal JAMA Neurology a team led by Michael Okun from the University of Florida in the US reviewed the contents of a registry set up in 2012 to record cases of the use of deep brain stimulation in the management of Tourette – a distressing condition manifested in uncontrollable vocal and physical tics.

The registry contained 185 reports of the procedure conducted since 2012, in 31 institutions in 10 countries. Okun and colleagues assessed 171 of them as meeting minimum criteria for inclusion in the review.

The researchers found that the procedure resulted in substantial improvement, with on average tic severity reduced by 45% within one year of the treatment starting. However, just over 35% of patients reported serious side-effects, notably difficulty controlling speech muscles and persistent feelings of pins-and-needles.

Okun’s team concluded that the results strengthened the idea that deep brain stimulation could be a useful surgical treatment for Tourette syndrome.

They cautioned, however, that doctors “should be aware of the high number of stimulation-related adverse events”, before adding that these were likely to be reversible.